| NPI | 1558372235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014221) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 6687) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2021-03-04 |